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Pediatric HIV/AIDS Surveillance
L262 slide series
(through 2001)
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Slide 1 - Title: Mother’s Exposure Category, by Year of Diagnosis for Perinatally Acquired AIDS, 1981- 2000, United States Changes have occurred in the distribution of exposure categories for the mothers of children who were infected perinatally and in whom AIDS developed. In the1980s, most of the women who transmitted HIV vertically were exposed to HIV through injection drug use, and a smaller proportion through heterosexual contact. In the 1990s, a smaller proportion of women who transmitted HIV vertically were exposed to HIV through injection drug use and a larger proportion through heterosexual contact. Slide 2 - Title: Reported AIDS in Children <13 Years of Age, by Exposure Category, 2001 and Cumulative, United States In 2001, 175 children with AIDS were reported to CDC, a marked decrease from 196 in 2000. Most (86%) of these children acquired HIV infection perinatally, that is, from their mother during pregnancy. Since the beginning of the AIDS epidemic, 9,074 children have been reported with AIDS. Again, most of these children (91%) were infected perinatally. Another 4% acquired HIV from a transfusion of blood or blood products, and another 3% acquired HIV from transfusion because of hemophilia.
Slide #1
Mother’s Exposure Category, by Year of Diagnosis for Perinatally Acquired AIDS, 1981- 2000, United States
Slide #2
Reported AIDS in Children <13 Years of Age, by Exposure Category, 2001 and Cumulative, United States
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Slide 3 - Title: Perinatally Acquired AIDS Cases, by Year of Diagnosis, 1985 - 2000, United States The estimated number of AIDS cases diagnosed among persons perinatally exposed to HIV peaked in 1992 and has decreased in recent years. The decline of these cases is likely associated with the implementation of Public Health Service guidelines for the universal counseling and voluntary HIV testing of pregnant women and the use of antiretroviral therapy for pregnant women and newborn infants (MMWR 2002;51[No. RR-18]). Other contributing factors are the effective treatment of HIV infections that slow progression to AIDS and the use of prophylaxis to prevent AIDS opportunistic infections among children. Slide 4 - Title: Zidovudine Use for HIV-infected Pregnant Women or for Perinatally Exposed or Infected Children Born 1993-2000, 39 States In April 1994, the Public Health Service released guidelines for the use of zidovudine (ZDV) to reduce perinatal HIV transmission; in 1995, recommendations for HIV counseling and voluntary testing for pregnant women were published, and in 2002 recommendations on the use of antiretroviral drugs in pregnant, HIV-infected women were updated. Since then, the proportion of perinatally HIV-exposed or infected children who received ZDV or whose mother had received ZDV has increased markedly. This increase in ZDV use, including receipt by the mother during the prenatal or the intrapartum period and receipt by the neonate, has been accompanied by a decrease in the number of perinatally HIV-infected children and is responsible for the dramatic decline in perinatally acquired AIDS. The data presented here are from the 39 states with name-based HIV infection surveillance, and may not represent all states in the US.
Slide #3
Perinatally Acquired AIDS Cases, by Year of Diagnosis, 1985 - 2000, United States
 Slide #4
Zidovudine Use for HIV-infected Pregnant Women or for Perinatally Exposed or Infected Children Born 1993-2000, 39 States
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Slide 5 - Title: AIDS Cases in Children Reported in 2001 In 2001, a total of 175 cases of AIDS in children younger than 13 years of age were reported, a decrease from 196 in 2000. Most of these cases were perinatally acquired. New York, Florida, California, and Pennsylvania reported the largest number of cases. In 2001, 22 states did not report any pediatric AIDS cases. Slide 6 - Title: Perinatally Acquired AIDS Cases, by Age at Diagnosis, 1982 - 2001, United States Perinatally acquired AIDS was diagnosed for nearly 40% of infected children within the first year of life and for 22% within the first 6 months. This distribution could change if more HIV-infected childbearing women become aware of their HIV status and seek medical care early in their infant’s life, when treatment could possibly prevent the progression from HIV infection to AIDS in their children.
Slide #5
AIDS Cases in Children Reported in 2001
 Slide #6
Perinatally Acquired AIDS Cases, by Age at Diagnosis, 1982 - 2001, United States
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Slide 7 - Title: Children <13 Years of Age Living with HIV Infection or AIDS, Reported through 2001 As of December 31, 2001, a total of 2,499 children in the United States, Guam, Puerto Rico, the US Pacific Islands, and the US Virgin Islands were reported to be living with AIDS. An additional 2,909 children were known to be infected with HIV and reported from the areas that conducted confidential name-based HIV infection case surveillance in 2001. The reported number of infected children is an underestimate of the population of infected children as some states, including several with high AIDS morbidity, do not report HIV infection to CDC. These data are useful in planning medical and social services to meet the current and future needs of this population. Slide 8 - Title: AIDS-defining Conditions Most Commonly Reported for Children <13 Years of Age, Reported through 2001, United States Certain clinical conditions are used to define AIDS among persons infected with HIV. The most commonly reported conditions for children are listed on this slide. From the beginning of the epidemic through 2001, 33% of children with AIDS had a diagnosis of Pneumocystis carinii pneumonia, another 23% a diagnosis of lymphoid interstitial pneumonitis, and 21% had recurrent bacterial infections.
Slide #7
Children <13 Years of Age Living with HIV Infection or AIDS, Reported through 2001
 Slide #8
AIDS-defining Conditions Most Commonly Reported for Children <13 Years of Age, Reported through 2001, United States
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Slide 9 - Title: AIDS-defining Conditions, by Age at Diagnosis for Perinatally Acquired AIDS Cases, Reported through 2001, United States The incidence of Pneumocystis carinii pneumonia (PCP) in children with perinatally acquired AIDS peaks at 3 to 6 months of age. The age at diagnosis for the other AIDS-defining conditions is much more evenly distributed during the first 2 years of life. Because PCP occurs early, prophylaxis is recommended for all perinatally HIV-exposed children, beginning at 6 weeks of age. The occurrence of PCP in children may indicate missed opportunities for testing pregnant women, the use of zidovudine or other antiretroviral therapies to prevent transmission, or therapy (including PCP prophylaxis) for HIV-exposed children. CDC has a high-priority initiative to reduce HIV transmission from mothers to children by promoting voluntary maternal testing prenatally (intrapartum if women do not receive prenatal care) and zidovudine therapy. Slide 10 - Title: Mother’s Exposure Category for Perinatally Acquired AIDS, by Year of Diagnosis, United States Since the beginning of the epidemic, the proportional distribution of exposure categories for HIV infection among mothers of children with perinatally acquired AIDS has changed. From 1996-2001, 21% of the mothers were exposed to HIV through injection drug use, and 36% did not specify an exposure category. From 1981 through 1995, a larger proportion (42%) of women were infected through injection drug use, and fewer (19%) were reported as having an unspecified exposure. It is likely that some proportion of the women without a specified risk were exposed through heterosexual contact.
Slide #9
AIDS-defining Conditions, by Age at Diagnosis for Perinatally Acquired AIDS Cases, Reported through 2001, United States
 Slide #10
Mother’s Exposure Category for Perinatally Acquired AIDS, by Year of Diagnosis, United States
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Slide 11 - Title: AIDS in Children <13 Years of Age, Reported in 2001 versus 2001 Population Estimates, by Race/Ethnicity, United States AIDS has disproportionately affected black children in the United States. Although only 14% of children in the United States are black, 65% of children reported with AIDS in 2001 are black. The proportion of children reported with AIDS who are Hispanic (15%) is slightly less than the proportion of US children who are Hispanic (19%). The proportion of cases among white and Asian/Pacific Islander children is lower than the proportion of children of these races/ethnicities in the total population. No American Indian/Alaska Native children were reported with AIDS in 2001. Slide 12 - Title: AIDS Rates (cases per 100,000) for Children <13 Years of Age, by Race/Ethnicity, Reported in 2001, United States The rate of AIDS among black children in 2001 was 1.4 (per 100,000) a rate 14 times higher than among white children (0.1) and 7 times higher than among Hispanic children (0.2). Because most pediatric cases of AIDS are attributed to perinatal HIV transmission, these rates also reflect the disproportionate racial/ethnic distribution of HIV and AIDS among black women in the United States.
Slide #11
AIDS in Children <13 Years of Age, Reported in 2001 versus 2001 Population Estimates, by Race/Ethnicity, United States
Slide #12
AIDS Rates (cases per 100,000) for Children <13 Years of Age, by Race/Ethnicity, Reported in 2001, United States
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Last Updated: March 14, 2003
Centers for Disease Control & Prevention
National Center for HIV, STD, and TB Prevention
Divisions of HIV/AIDS Prevention
Surveillance Branch
Contact Us